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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073408899
Report Date: 06/25/2024
Date Signed: 06/25/2024 03:38:40 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/07/2024 and conducted by Evaluator Cherie Acosta
COMPLAINT CONTROL NUMBER: 02-CC-20240507152355
FACILITY NAME:GODDARD SCHOOL, THEFACILITY NUMBER:
073408899
ADMINISTRATOR:KATHERINE ESPANOL RIVASFACILITY TYPE:
830
ADDRESS:115 TECHNOLOGY WAYTELEPHONE:
(925) 390-3313
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY:24CENSUS: 13DATE:
06/25/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Director Katherine Rivas.TIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Facility is out of ratio
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cherie Acosta and Dealia Frison conducted an unannounced visit to investigate the above allegation. LPAs met with Director Katherine Rivas.

During the investigation LPAs toured the facility, reviewed documents and conducted interviews. Based on the investigation the facility has operated out of ratio. An aide who has completed 9 ECE units and is currently enrolled in an infant course has supervised infants without a qualified teacher present.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 02-CC-20240507152355
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: GODDARD SCHOOL, THE
FACILITY NUMBER: 073408899
VISIT DATE: 06/25/2024
NARRATIVE
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Based on interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is to be substantiated.

See 9099-D for deficiency cited today

Exit interview was conducted and report was reviewed with Katherine Rivas and Geetha Venkataganesh

Notice of Site Visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 02-CC-20240507152355
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: GODDARD SCHOOL, THE
FACILITY NUMBER: 073408899
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/05/2024
Section Cited
CCR
101416.2(b)
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Infant Care Teacher Qualifications and Duties.Prior to employment, an infant care teacher shall have completed, with passing grades, at least three postsecondary semesters or equivalent quarter units in early childhood education or child development, and three
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Director shall develop a written plan explaining how the facility will remain in ratio at all times. Director shall submit a copy of this plan to CCL by 7/5/24.
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postsecondary semester or equivalent quarter units related to the care of infants, at an accredited or approved college or university. This requirement was not met as evidenced by: Infants have been supervised by an aide without a qualified teacher which is a potential risk to the health and safety of children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3